MAY PPAR GAMMA BE SIGNIFICANT IN BIPOLAR DISORDER ONLY IN THE PRESENCE OF METABOLIC SYNDROME?

Background: Peroxisome proliferator-activated receptor γ (PPARγ) has a key role in regulating both neurogenesis and various metabolic processes, including adipogenesis and glucose homeostasis. In this study, it was aimed to compare the serum PPARγ levels and metabolic syndrome (MetS) parametres of patients with Bipolar Disorder (BD) diagnosed manic-depressive-euthymic episodes with those of healthy subjects. Subjects and Methods: We included 121 male patients with BD type I, 44 in mania, 35 in depression and 42 in euthymic state, and 41 healthy controls. Serum PPARγ levels, inflammation indicators (CRP, neutrophil, leukocyte, and albumin) and Mets parametres were measured. Results: There were no statistically significant differences between the groups in terms of PPARγ values. PPARγ serum level is highest in the control group and then euthymic, manic and depressive episodes continue to decrease, respectively. However, there was a significant difference between the depressive group with MetS and without MetS in terms of serum PPARγ levels. A statistically significant correlation was found between PPARγ and the other serum markers such as low-density lipoprotein (p=0.022), HbA1c (p=0.002), neutrophils levels (0.001), white blood cell (p=0.025), and clinical features such as age at first treatment (p=0.024), age at first episode (p=0.039), and smoking (0.013). Conclusions: We suggest that PPARγ may be a key factor in the BD depressive group with MetS. Not finding any relationship between the PPARγ levels and the episode of BD may be related with the absence of MetS in the individuals. MetS parametres must also be considered if PPARγ is to be evaluated in the future investigations

Serum Neopterin and Procalcitonin Levels in Relationship with Pediatric Burn Wound Infections

Infection and septic complications in burn patients can be monitored by procalcitonin (PCT) and neopterin plasma values. The aim of the study was to investigate serum neopterin and PCT levels with WBC (white blood cell) and CRP (C-reactive protein) levels in patient group (PG) and healthy control group (HCG) and to investigate the relationship of these markers with burn wound infections (BWI). As the PG, 23 patients between 0–12 ages and up to 30% Total Body Surface Area (TBSA) burned and 15 HCG were included. PCT, neopterin, WBC, and CRP results on the first, the seventh, the fourteenth and the 21st day have been compared. During the follow-up period, 11 patients with BWI and 12 patients without BWI were classified as infected and non-infected patients, respectively. PCT and neopterin levels were detected higher in patients with BWI but no significant difference were present. Also, PCT and neopterin levels within the first 24 hours following the burn were detected higher in PG than HCG. CRP and WBC levels were detected high due to burn trauma. PCT and neopterin levels were increased in patients with BWI. PCT levels were increased during the pre-infectious period, while neopterin levels increased during the post-infectious period

Problems encountered in conventional HIV 1/2 Algorithms: lack of necessity for immunoblot assays to confirm repeated ELISA reactive results

Background: The use of conventional (serologically based) HIV 1/2 diagnostic algorithms has become controversial in recent years.Objectives: Sera from patients who underwent verification tests were evaluated because repeated ELISA-reactive results demonstrated a HIV1+HIV2 positive band pattern.Methods: The line immunoassay (LIA) test was used for repeated HIV enzyme immunoassays (EIA)-reactive sera in patients at three centers. The Bio-Rad Geenius™ HIV 1/2 and the HIV-1 RNA tests were used. HIV-1 and RNA HIV-2 were investigated using PCR.Results: LIA was used to evaluate 3,224 out of 10,591 samples with repeated ELISA reactivity (30%). We found that 32 (1%) of the sera, along with HIV1 bands and HIV2 gp36 bands, were positive. Only 28 of the 32 verified serum samples with gp36 bands were repeated, and no gp36 band positivity was detected using the Bio-Rad Geenius™ HIV-1/2 confirmatory assay in these serum samples. The HIV-2 proviral DNAs were also negative. Therefore, we excluded the possibility of HIV1+2 co-infection. All samples from the 32 patients were positive for HIV-1 RNA.Conclusion: Our findings highlight the need to exclude confirmatory tests like the LIA test from the current diagnostic HIV algorithm and replace it with rapid HIV-1 and HIV-2 confirmatory immunochromotographic tests.Keywords: HIV, AIDS, HIV-2

Reducing the environmental impact of surgery on a global scale: systematic review and co-prioritization with healthcare workers in 132 countries

Abstract Background Healthcare cannot achieve net-zero carbon without addressing operating theatres. The aim of this study was to prioritize feasible interventions to reduce the environmental impact of operating theatres. Methods This study adopted a four-phase Delphi consensus co-prioritization methodology. In phase 1, a systematic review of published interventions and global consultation of perioperative healthcare professionals were used to longlist interventions. In phase 2, iterative thematic analysis consolidated comparable interventions into a shortlist. In phase 3, the shortlist was co-prioritized based on patient and clinician views on acceptability, feasibility, and safety. In phase 4, ranked lists of interventions were presented by their relevance to high-income countries and low–middle-income countries. Results In phase 1, 43 interventions were identified, which had low uptake in practice according to 3042 professionals globally. In phase 2, a shortlist of 15 intervention domains was generated. In phase 3, interventions were deemed acceptable for more than 90 per cent of patients except for reducing general anaesthesia (84 per cent) and re-sterilization of ‘single-use’ consumables (86 per cent). In phase 4, the top three shortlisted interventions for high-income countries were: introducing recycling; reducing use of anaesthetic gases; and appropriate clinical waste processing. In phase 4, the top three shortlisted interventions for low–middle-income countries were: introducing reusable surgical devices; reducing use of consumables; and reducing the use of general anaesthesia. Conclusion This is a step toward environmentally sustainable operating environments with actionable interventions applicable to both high– and low–middle–income countries

A Review of Multimedia Learning Principles: Split-Attention, Modality, and Redundancy Effects

This study aims to present a literature review on three principles of multimedia learningincluding split attention, modality, and redundancy effects with regard to their contribution to cognitiveload theory. According to cognitive load theory, information should be presented by considering excessiveload on working memory. The first principle states that attending to two distinct sources of informationmay impose a high cognitive load, and this process is referred to as the split-attention effect (Kalyuga,Chandler & Sweller, 1991, 1992). The second principle, Modality effect claims that on-screen text shouldbe presented in an auditory form instead of visually when designing a multimedia environment (Moreno &Mayer, 1999). Using more than one sensory mode augments forceful working memory that producesprogressive effects on learning. The third principle redundancy effect occurs when information presentedrepeatedly interferes with learning. This study provides guidance how to create more effective instructionwith multimedia materials for instructional designers

CLUSTER HEADACHE ASSOCIATED WITH KLEINE-LEVIN SYNDROME IN A YOUNG MALE PATIENT

WOS: 000444558903264

Coupling ion exchange with ultrafiltration for boron removal from geothermal water-investigation of process parameters and recycle tests

A hybrid process was established in a stirred vessel coupling ion exchange with ultrafiltration (UF). Boron selective chelating ion-exchange resins Dowex XUS-43594.00 with an average particle diameter of 20 mu m were used for boron separation from geothermal water and a submerged hollow fiber type UF membrane module (ZW-1, GE) was used for the filtration of the resin suspension and collecting permeate. Process variables such as the concentration of ion exchange resin in the suspension, replacement rates of fresh and saturated resins in the stirred vessel, and flow rate of permeate were evaluated in order to determine the efficiency of the hybrid process for boron removal from geothermal water. The recycle performance of the hybrid system was monitored following ten sorption-washing-elution-washing-regeneration-washing cycles. (C) 2013 Elsevier B.V. All rights reserved

An innovative integrated system for boron removal from geothermal water using RO process and ion exchange-ultrafiltration hybrid method

WOS: 000317945300001In this study, removal of boron from the geothermal water was investigated by an integrated process coupling reverse osmosis (RO) with ion exchange-ultrafiltration hybrid method. Desalination tests were performed by using a mini-pilot scale brackish water reverse osmosis (BWRO) system which was installed at Yenikale Geothermal Heating Center, Izmir. Boron selective chelating ion exchange resin Dowex (XUS 43594.00) with a particle size of 20 mu m was employed for removal of boron from BWRO permeate of geothermal water. A submerged hollow fiber type ultrafiltration membrane module (ZW-1) was used for filtration. Effect of such process variables as resin concentration in the suspension, flow rates of fresh and saturated ion exchange resins, and flow rate of permeate on the efficiency of the hybrid process for boron removal from RO permeate of geothermal water was studied. (C) 2013 Elsevier B.V. All rights reserved.National Boron Research Institute of Turkey, BORENMinistry of Energy & Natural Resources - Turkey [2008-G-0192]This study was supported by the National Boron Research Institute of Turkey, BOREN (Project no. 2008-G-0192). We thank Izmir Geothermal Energy Co. for the kind permission and support to perform RO tests in the geothermal heating center. We also acknowledge Dow Chem. for sending us boron selective ion exchange resin Dowex XUS-43594.00. We are grateful to Prof. M. Bryjak, Wroclaw University of Technology, Poland for his great encouragement on the subject research. We appreciate also reviewers for their kind comments and suggestions to improve this manuscript